The clinical manifestations due to Wind mimic the action of wind itself in nature: Wind tends to rise, disperse, move upward and outward. The essence of Wind is movement and change. It tends to migrate to various parts of the body, come and go, change direction and location, alternate in intensity of symptoms or periodically disappear altogether. Just as wind in Nature sways the top of trees, symptoms of pathogenic Internal-Wind are characterized by vibration and involuntary movement, such as tremors, convulsions and vertigo. It is because of its movement that it is considered a Yang evil.
Pathogenic Wind usually attacks the upper and outer Yang parts of the body first, such as the head and face, and the skin and muscle, resulting in such symptoms as headache, dizziness, spasms, rigidity of the muscles and deviation of the eye and mouth. It also brings on sudden colds with headache, stuffy nose, chills and fever. At other times it causes a stiff or rigid neck and shoulders. Often people will remember being exposed to a draft before these symptoms began.
Wind, both exterior and interior, acts fast. For example, an invasion of exterior Wind resulting in a common cold comes quite suddenly; the associated symptoms will typically take less than 24 hours to appear.
External Wind-Cold may produce quite rapid changes in symptoms from one day to the next or even within a day: this is especially common in children. Another good example of rapid clinical changes are those occurring in skin diseases from Wind.
An example of this is the movement of pain from one joint to the other in Painful Obstruction Syndrome (so-called "Bi Syndrome").
Wind can produce two opposite set of symptoms, either involuntary movements, such as tremors, or the lack of movement, for example paralysis or stiffness. All involuntary movements, such as the tremors of Parkinson’s disease, tics or convulsions during a febrile disease, are due to internal Wind ‘shaking the sinews’.
Wind often causes numbness and/or tingling. For example, numbness of the first three fingers of the hand may be a sign of Wind-stroke. Numbness of the face may be due to invasion of external Wind in the Connecting (Luo) channels of the face.
External Wind causing Wind Painful Obstruction Syndrome (so-called "Bi Syndrome") will typically affect the top part of the body: for example, the neck and shoulders.
Internal Wind may cause headache and vertigo. Skin diseases from Wind will affect the head and hands primarily.
Internal Wind always involves a Liver pathology. The symptoms of Wind, such as vertigo, are due to the rising of Liver-Qi to the top of the body. Tremors and convulsions are due to the ‘shaking of sinews’, which are controlled by the Liver.
Wind can cause a large number of skin diseases characterized by generalized itching or skin rashes with sudden onset. Liver-Blood deficiency may give rise to Wind in the skin, causing itching: this is seen, for example, in itching in menopausal women.
External Wind invades the Lungs' Defensive Qi portion (the ‘Exterior’ of the body), causing symptoms such as aversion to cold, fever, headache or a Floating pulse. External Wind may be combined with Cold, Heat, Dampness and Dryness.
Exterior Wind can invade the channels of the face directly and cause facial paralysis. It can also invade any channel, particularly the Yang channels, and settle in the joints, causing stiffness and pain of the joints (Painful Obstruction Syndrome). The pain would typically be ‘wandering’, moving from one joint to another on different days.
Finally, Wind can also affect some Internal Organs, principally the Liver. Wind pertains to Wood and the Liver according to the Five-Element system of correspondences.
Exterior Wind penetrates via the skin and interferes with the circulation of Defensive Qi in the space between skin and muscles. Since Defensive Qi warms the muscles, when its circulation is impaired by Wind, the person feels chilly and has aversion to cold. ‘Aversion to cold or wind’ is a key symptom of invasion of exterior Wind.
The Lungs control the spread of Defensive Qi to the Exterior of the body. The presence of Wind in the space between skin and muscles and its interference with Defensive Qi results in a general disharmony of Lungs-Qi. This impairment of the diffusing and descending of Lungs-Qi prevents the spreading and descending of Lungs fluids, resulting in a runny nose with profuse white discharge.
The fight between the pathogenic Wind and Defensive Qi in the skin and muscles may cause a ‘fever’ that is not necessarily an actual fever but rather an objective hot feeling of the patient’s body on palpation.
Wind attacks the most superficial channels first, which are the Greater Yang channels (Small Intestine and Bladder), and obstructs the circulation of Defensive Qi within them: this causes stiffness and pain along these channels and particularly in the back of the neck.
Wind attacks the top part of the body and often lodges in the throat, causing an itchy sensation in the throat.
If Wind combines with Cold with a prevalence of the latter, there will be no sweating because Cold contracts the pores. The pulse will be Tight. This is more likely to happen when a person has a relatively strong constitution and a tendency to Excess patterns: then the body’s Defensive Qi reacts strongly, the pores will be closed and there will be no sweating. This is an Exterior-Excess pattern.
If the Cold is not so prevalent but Wind predominates, the pores are open, the person sweats slightly and the pulse will be slow. This is more likely to happen to a person with a relatively weak constitution and a tendency to Deficiency patterns: then the Nutritive Qi (Ying Qi) is weak, the pores are open and there will be a slight sweating. This is an Exterior-Deficient pattern. Please note that although Chinese texts describe this pattern as ‘Exterior-Deficient’, they do so only in opposition to the invasion of Wind-Cold with the prevalence of Cold that is described as ‘Exterior-Excess’. But both these patterns are Full patterns from the point of view of the Eight Principles as they are characterized by the presence of a pathogenic factor (Wind).
The main symptoms of Wind-Cold are an aversion to cold, sneezing, cough, runny nose with white watery mucus, fever, severe occipital stiffness and headache, no sweating, no thirst, Floating-Tight pulse, tongue body colour unchanged, thin white coating.
This is roughly the same as in Wind-Cold, except that since Wind is combined with Heat, there are some Heat signs, such as thirst, yellow mucus, more fever, a rapid pulse and a slightly Red tongue body on the tip or sides.
There is aversion to cold in invasions of Wind-Heat because this interferes with the circulation of Defensive Qi in skin and muscles. Since Defensive Qi warms the muscles, an impairment of its circulation leads to aversion to cold in the beginning stages.
The main symptoms of Wind-Heat are an aversion to cold, fever, sneezing, cough, runny nose with slightly yellow mucus, occipital stiffness and ache, slight sweating, itchy throat, sore throat, swollen tonsils, thirst, Floating-Rapid pulse, Tongue body colour Red on the tip or sides, thin white coating.
This consists in invasion of exterior Wind and Dampness at the beginning stages. Dampness has an obstructive quality: when it obstructs the Connecting channels, it causes swollen glands in the neck; when it obstructs the muscles, it causes muscle ache and feeling of heaviness of the body; when it obstructs the joints, it causes joint ache.
The main symptoms of Wind-Dampness are an aversion to cold, fever, swollen neck glands, nausea, sweating, occipital stiffness, body aches, muscle ache, feeling of heaviness of the body, swollen joints, Floating-Slippery pulse.
This is Wind-Heat with Dryness at the Defensive Qi level and, for this reason, there is aversion to cold. Other symptoms are due to Dryness injuring Body Fluids.
The main symptoms of Wind-Dryness are an a fever, slight aversion to cold, slight sweating, dry skin, nose, mouth and throat, dry cough, sore throat, dry tongue with thin white coating, Floating-Rapid pulse.
External Wind can invade the body without causing ‘exterior symptoms’: that is, the aversion to cold and fever that we get when we
catch the common cold for instance.
In some cases, external Wind can simply invade the channels of the face, causing facial paralysis. This is called peripheral facial paralysis in Western medicine (as it involves only the peripheral nerves) to distinguish it from the ‘central’ facial paralysis caused by a stroke (which involves the central nervous system).
As Wind contracts and stiffens things, an invasion of external Wind in the channels of the face causes facial paralysis: this involves especially the Stomach and Large Intestine channels. Chinese medicine makes a further distinction in terms of channels affected as, if external Wind affects the main channels of the face, it causes paralysis; if it affects only the Connecting channels of the face, it causes purely numbness.
Another type of invasion of external Wind without exterior symptoms is when external Wind invades the channels and settles in the joints: this is called Painful Obstruction Syndrome (Bi Syndrome).
When Wind is the main cause of Painful Obstruction Syndrome, the joint pain is typically ‘wandering’ (it moves from joint to joint).
External Wind may also aggravate a condition of Liver-Yang rising and precipitate a headache: migraine sufferers (when this is caused by Liver-Yang rising) often report that a migraine attack may be precipitated by windy weather.
Wind in the skin plays a major role in skin diseases: it is a special type of Wind that is neither external nor internal, or both at the same time. However, it is best categorized and discussed under external Wind. Wind in the skin may be seen as a type of external Wind in so far as many skin diseases may be caused or aggravated by external wind.
The chief characteristics of Wind in the skin are:
The main symptoms of interior Wind are: tremors, tics, severe dizziness, vertigo and numbness. In severe cases, there are convulsions, unconsciousness, opisthotonos, hemiplegia and deviation of mouth.
Interior Wind is always related to a Liver disharmony. It can arise from several different conditions: